Myeloproliferative Disorders and the Chronic Leukemias: Symptom Burden and Impact in Quality of Life

  • R. A. Mesa
  • D. P. Steensma
  • T. Shanafelt
Reference work entry


Optimizing health-related quality of life (QOL) is an important goal for patients with any hematological malignancy, but for those who suffer from disorders that follow a relatively indolent yet refractory course, QOL is an especially prominent consideration. These latter conditions include the chronic myeloproliferative disorders (MPD), myelodysplastic syndromes (MDS), and chronic lymphocytic leukemia (CLL) – diseases that are rarely curable, but that are often associated with prolonged survival. The MPD include polycythemia vera, essential thrombocythemia, and myelofibrosis (which can be primary, or can arise during the course of polycythemia vera or essential thrombocythemia). MPD-associated symptoms that compromise QOL include pruritus, night sweats, unintentional weight loss, loss of lean muscle mass, and profound fatigue, while QOL-impairing complications include thrombosis, bleeding, and often-dramatic splenic enlargement. Likewise, MDS suffer symptoms related to cytopenias, and CLL patients must contend with cytopenias, complications related to adenopathy and splenomegaly, and “B symptoms” (night sweats, weight loss, and unexplained fevers). By directly surveying large cohorts of MPD, MDS, and CLL patients using validated QOL instruments, we demonstrated that the burden of symptoms in these patients is severe, and that excessive fatigue is the most common and troublesome symptom of all, far exceeding levels reported for matched disease-free controls in the general population. Management of patients with MPD, MDS, or CLL needs to take into consideration QOL issues, and clinical trials of therapeutic agents should include improved QOL as a valid treatment endpoint.


Chronic Lymphocytic Leukemia National Comprehensive Cancer Network Polycythemia Vera Essential Thrombocythemia Chronic Lymphocytic Leukemia Patient 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

List of Abbreviations:


Brief Fatigue Inventory


Chronic Lymphocytic Leukemia


Chronic Myelomomonocytic Leukemia


Erythropoietin Stimulating Agent


Essential Thrombocythemia


Functional Assessment of Cancer–General


Federal Drug Administration


Myelodysplastic Syndrome


Myeloproliferative Disorder


Polycythemia Vera


Post Essential Thrombocythemia Myelofibrosis


Post Polycythemia Vera Myelofibrosis


Primary Myelofibrosis


Quality of Life


Refractory Anemia


Refractory Anemia with Excess Blasts


Refractory Anemia with Excess Blasts in Transformation


Refractory Anemia with Ringed Sideroblasts


Refractory Cytopenia with Multilineage dysplasia


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© Springer Science+Business Media LLC 2010

Authors and Affiliations

  • R. A. Mesa
  • D. P. Steensma
  • T. Shanafelt

There are no affiliations available

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